New figures show rise in smokers switching to e-cigarettes in Wales

]E-cigarette use is rising across Wales and more tobacco smokers are quitting the habit, according to the latest YouGov survey by ASH Wales.

The figures reflect the growth in e-cigarette use across Great Britain, where nearly half as many people vape as smoke.

New data published by ASH shows that there are now an estimated 3.6 million vapers compared to 7.2 million smokers in Britain.  In Wales 7% of the adult population now vape, compared to 17% that smoke [1]. This compares to 5% of the population in 2018 when 19% of adults smoked.

There has been an increase too in the numbers of ex-smokers who now vape. The National Survey for Wales shows that in 2016/17 52% of e-cigarettes users also smoked cigarettes. This fell to 47% in 2017/18.

Across the UK the number of vapers who are ex-smokers reached 54.1% in 2019 with the main reason given for using e-cigarettes being to help them quit (31%), following by to prevent them from relapsing back to smoking (20%). Of those surveyed by ASH Wales, 74% of e-cigarette users cited health as their main reason for vaping and 57% of e-cigarette users said vaping had improved their quality of life.

Suzanne Cass, CEO of ASH Wales said: “The rise in the numbers of ex-smokers who now vape in Wales shows that many smokers are using e-cigarettes to quit.

“Indeed, when coupled with behavioural support e-cigarettes have been shown to be one of the most effective ways to give up smoking, enabling thousands of smokers in Wales to break a habit that destroys lives.

“However, with more than double the amount of people in Wales smoking compared to vaping, we still face a major challenge when it comes to changing people’s behaviour and de-normalising what has become an entrenched habit in many of our most deprived communities. We know that 29% of smokers in Wales are yet to try an e-cigarette which shows many could be missing out on an opportunity to attempt quitting.”

Despite the increase in the number of people vaping the survey revealed that perceptions of the relative harm of e-cigarettes compared to tobacco cigarettes, have worsened. Now almost a third of people in Wales (27%) wrongly believe e-cigarettes are equally or more harmful than tobacco cigarettes compared to 24% in 2018.

Suzanne Cass said: “There is work to be done when it comes to raising awareness of the relative harm of e-cigarettes compared to tobacco cigarettes and addressing concerns about the safety of vaping.

“Evidence from Public Health England has shown that e-cigarettes are significantly less harmful than smoking tobacco cigarettes and have also been proven to be a highly effective smoking cessation tool.”

Since the survey was carried out, reports of a possible link between e-cigarette use and deaths from lung disease in America have led some medical experts to warn of the dangers of vaping.  According to the US Centers for Disease Control and Prevention many of those vapers affected had used products with liquids containing cannabinoid products.

Vapers, or those considering vaping, should be reassured that e-cigarettes are regulated in the UK in line with a set of European-wide rules by the medicines regulator, the MHRA. The MHRA also monitors adverse reactions through its yellow card system, which to date has not identified serious respiratory problems similar to that found in the US.

Meanwhile vapers in the UK are being urged to only ever purchase e-cigarettes from reputable suppliers.

[1] This figure is cited in the National Survey for Wales 2018/19

Cardiff Metropolitan University is set to go smokefree

At the start of the new academic year, Cardiff Metropolitan University announces its ambition to become a smokefree university within a year.

Today, the university, which hosts more than 10,000 students across two sites in the city, has launched plans to become a clean-air campus, creating a healthier environment for staff, students and visitors.

As one of the UK’s leading universities for practise focused studies, the plans will form part of its overarching health and well-being strategy, with the aim of becoming completely smokefree by 2020.

To support the new policy, tobacco products will no longer be sold on its campuses and more support on stop smoking services will be provided to students that want to quit.

Suzanne Cass, CEO of ASH (Action on Smoking and Health) Wales, which supported Cardiff Met’s bid to become a smokefree university, congratulated the university on the success of the project and said she hoped other universities in Wales would follow suit.

“It is a great privilege to have worked on this project and we are delighted to see two years of hard work coming to fruition and the creation of a clean air campus that will bring huge benefits to both staff and students.

“Attitudes towards smoking in Wales are changing and the public are keen to see action taken to tackle smoking prevalence, including the introduction of smokefree spaces. We very much hope that Cardiff Metropolitan’s forward-thinking approach will be emulated by other universities across Wales as we believe action to de-normalise and reduce smoking should form a key part of every university’s health and well-being agenda.”

Pro-Vice Chancellor and Exec Dean of the School of Sport and Health Sciences Leigh Robinson, said:

“Our communities’ commitment to becoming smoke free by 2020 emphasises the vital role we all play in supporting a healthier environment for one another. We are delighted to be leading the way in creating a healthier environment for staff, students and visitors.
“I’d like to thank our staff and students for working towards this goal. Together, our commitment to becoming a healthier university will grow from strength to strength.”

Across Wales 22% of 16 to 24-year-olds smoke, compared to 17% of the overall adult population. Since the smoking ban in enclosed public spaces came into force in 2007, smoking prevalence among the public has fallen by 6%, and the largest fall in smoking prevalence in the UK since 2011 has been among 18 to 24-year-olds. Smoking costs the Welsh NHS £302 million a year.

According to ASH Wales’ latest YouGov survey there is strong support for additional tobacco control policies in Wales. Of those surveyed, 59% said they would support a ban on smoking in all town centres in Wales and 63% agreed smoking should be banned in the outdoor eating areas of cafes and restaurants. Nearly half (47%) of Welsh adults feel the government is not doing enough to reduce smoking prevalence in Wales, up from 39% in 2018.

Is Vaping Safe?

Reports of a possible link between e-cigarette use and deaths from lung disease predominantly in America have led some medical experts to warn of the dangers of vaping.

In a bid to answer some of the questions vapers may have in the wake of media reports about the situation in America, we contacted the UK government organisation responsible for regulating e-cigarette products in the UK, the Medicines and Healthcare products Regulatory Agency (MHRA).

Is it safe to vape in the UK, given the cases that are being investigated in the US?

E-cigarette products are regulated and must meet safety and quality standards before they can be sold in the UK.

The MHRA is aware of reports in the USA regarding a number of patients falling ill following vaping and are reviewing the available information. The MHRA assess all reports received in association with nicotine-containing e-cigarettes and should any potential safety concerns be identified we will take appropriate action to protect public health.”

What do we know about why people have been falling ill after using an e-cigarette in the US?

According to the U.S. Centers for Disease Control many patients affected by possible cases of lung illness report using e-cigarette products with liquids that contain cannabinoid products, such as tetrahydrocannabinol (THC).

Are vape products containing THC sold in the UK?

THC is a controlled substance in the UK and there are no vaping products containing THC which are approved for sale on the UK market.

Recreational use of THC is illegal and the use of illicit drugs can have potentially dangerous side effects because they have not been subject to the safety and quality standards put in place to protect public health.

What advice would you give to people concerned about using e-cigarettes in Wales?

It is advised that vaping products are not modified or used with homemade or black market cartridges, containing illicit substances, in order to preserve the health of their users.

The MHRA runs the notification scheme in the UK for e-cigarettes devices and nicotine containing e-liquids, which in order to be notified need comply with the Tobacco and Related Product Regulations. We encourage all consumers to ensure that they are buying notified products from reputable retailers. The MHRA also receives reports of potential safety concerns and work with local Trading Standards teams to investigate as needed.

Have there been any reports of people falling ill in the UK after using an e-cigarette?

Between 20/05/2016 – 06/09/2019, the MHRA has received 62 spontaneous UK Yellow Card reports of adverse reactions associated with nicotine-containing e-cigarettes. The MHRA encourages members of the public and healthcare professionals to report any potential side-effects associated with e-cigarettes to the Yellow Card Scheme (https://yellowcard.mhra.gov.uk/).

It is essential to note that a report of an adverse reaction does not necessarily mean that it was caused by the e-cigarette, but a suspicion by the reporter that the e-cigarette may have been the cause. Other factors such as the underlying disease or concomitant medicines may contribute to suspected adverse reactions.

Smokers 30 times more likely to develop mouth cancer if they mix tobacco and alcohol, warns leading academic

Having a drink whilst smoking, dramatically increases a person’s chance of developing mouth cancer

Smokers mix alcohol tobacco
Michael Lewis, Professor of Oral Medicine at Cardiff University’s School of Dentistry

That’s the warning from Michael Lewis, Professor of Oral Medicine at Cardiff University’s School of Dentistry who said smokers are 30 times more likely to develop mouth cancer if they mix alcohol and tobacco.

He said the risk of mouth cancer rises sharply in those who drink alcohol while smoking as it enables chemicals from the tobacco to be drawn more easily into the lining of the mouth:

“Tobacco alone is a factor in 60% of cases of mouth cancer whilst alcohol is a factor in 30% of cases. However, when the two habits are combined, there is a 30-times increase in the likelihood of developing this form of cancer,” said Professor Lewis.

“Tobacco contains a range of harmful chemicals known to cause cancer called carcinogens. When tobacco smoke mixes with alcohol in the mouth, these chemicals are drawn into the soft tissues lining the mouth which subsequently undergoes malignant change,” he added.

Professor Lewis went on to say that he believes smokers are “relatively unaware” of the risk of developing mouth cancer as a result of their habit, compared to the risk of lung cancer.

Mouth cancer is usually painless in its early stages but can produce a variety of changes in the mouth, including an ulcer, red or white patch or swelling. It is treated by radiotherapy or surgery, yet, according to Professor Lewis, more than half of sufferers die within five years of diagnosis. [i]

Suzanne Cass is CEO of the tobacco control campaign group ASH Wales. She said:

“For many smokers a cigarette and a drink go hand in hand. But as we now know, alcohol and tobacco are a lethal combination.

“Smoking is not a normal lifestyle choice, it is a devastating addiction that destroys the lives of thousands of smokers and their families in Wales every year.

“We would urge those in the grip of this addiction to seek help to give up from NHS Wales’ free smoking session service Help Me Quit.”

National alcohol charity Alcohol Change UK is holding its annual Wales conference on 18th September at Glyndŵr University which will focus on the links between alcohol and other issues, including smoking, gambling and mental health problems.

Andrew Misell, Director for Wales at Alcohol Change UK , said:

“Alcohol problems rarely occur in a vacuum. There are many reasons that people drink to excess: and many other issues that go hand in hand with drinking, including tobacco use. Many of these other issues, including smoking, exacerbate the issues caused by heavy drinking.

“Because people with alcohol problems have such diverse and complex needs, support services need to be ready to deal with that and provide support for people who don’t fit neatly into one treatment category. That’s what we’ll be focussing on at our conference, and we hope to see a wide range of professionals there who are keen to take a whole-person approach to their work.”

Research from the National Institute on Drug Abuse found that cigarette smoking increases the likelihood of relapse among people recovering from substance misuse disorder and has suggested that helping people to quit smoking improves their chances of recovery from use of other drugs such as alcohol.

People with substance misuse disorders are two to four times more likely to smoke than the general population and research has shown there is a higher smoking prevalence amongst those misusing other substances.

If you are a smoker who would like to find out more about support to quit, contact Help Me Quit on 0800 085 2219 or visit the ASH Wales website.

If you are worried that you are drinking too much you can use Alcohol Change UK’s drinking quiz to see how risky your drinking is. Support to cut down is available if you need it; you can visit your GP or local alcohol service to get the right help for you.

[1] Lewis M A O. Mouth cancer: Presentation, detection and referral in primary dental care.  Br Dent J 2018; 225: 833-840.

What are the best ways to give up smoking?

When quitting smoking it is important to do your research to find the best method that works for you. Quitting is a personal thing and there isn’t always a one size fits all answer.

There are however some quit methods that may give you a better chance of success…..

1) NHS Help and Support

From nicotine replacement therapy (NRT) products to e-cigarettes, there are plenty of options available to help you quit for good. Using these products in combination with support from local stop smoking services means you have an even greater chance of success. Smokers who give up using free NHS support are said to be 3x more likely to quit for good.

Help Me Quit is run by NHS Wales and will help you to find the quit smoking support that suits you best – whether that’s weekly group sessions in your local area or one to one meetings with a smoking cessation advisor. The service is tailored to meet your needs and you will be supported along the way with access to NRT and behavioural support.

2) E-cigarettes

The growth in the popularity of e-cigarettes has seen them become one of the UK’s most popular quit tools. They allow smokers to inhale nicotine in a vapour and do not burn like tobacco-cigarettes. Experts estimate that e-cigarettes are at least 95% less harmful than cigarettes.

They are popular with smokers trying to quit as you still get the nicotine, the hand to mouth gesture and the visual effect of the exhaled smoke without the other harmful chemicals contained in tobacco cigarettes.

E-cigarettes come in different models, with plenty of options, however it is important to make sure you’re buying your e-cigarette from a credited business that meets regulations.

Read our interview with some of Wales’ vape shop owners 

3) Understanding your habits

Smokers often struggle when trying to quit as the nicotine hit is gone but the daily habits and rituals are still there. As well as treating the physical addiction, in order to quit successfully you also need to address your patterns of behaviour and psychological addiction.

If you’re trying to quit – try changing your routine or finding alternative activities that don’t trigger the urge to light up a cigarette.

Read our article on smoking and the unconscious brain

Like we said at the start, there is no one size fits all method to quitting smoking and you might need to try a few different approaches until you find the option that works best for you.

Seeking support from a local NHS service however is proven to be effective, with smokers 3x more likely to quit successfully than if they go it alone!

Is smoking bad for your brain?

The brain controls every aspect of our lives and the impact of it being damaged in any way can be devastating.  We all take steps to protect our brains, such as wearing a cycling helmet or avoiding knocks to the head. But did you know that giving up smoking is also a great way to prevent damaging our precious grey matter?  Here’s why smoking is bad for your brain: 

The cycle of addiction

Nicotine addiction is so powerful that it causes changes in your brain that will affect your moods, leading to anxiety and irritability. The brain develops extra nicotine receptors to deal with the large doses of nicotine you inhale. As soon as the brain stops being fed with the nicotine, withdrawal symptoms kick in, leading to mood changes.  Smokers will then smoke to relieve these symptoms, flooding their brains with nicotine once again. And so the cycle continues…

Long term damage

Researchers have found that smoking does long term damage to the structure of the brain. A study carried out in 2015 and published in the Molecular Psychiatry journal, looked at the brain scans of 500 smokers, non-smokers and former smokers. It found that current and former smokers actually have a thinner cortex, the part of the brain that deals with memory, language and cortex, than non-smokers. The cortex does thin naturally with age, but the researchers found that smoking accelerates that process, leading to mental decline. On a more positive note, however the researchers did find that stopping smoking leads to some restoration of the cortex – albeit a slow one.

Stroke

According to the Stroke Association, smokers are twice as likely to die if they have a stroke.  Smoking greatly increases your risk of having a stroke with those who smoke 20 a day, six times more likely to have a stroke than a non-smoker. There are different reasons for this. One is due to the 7,000 toxic chemicals contained in tobacco smoke which enter your blood stream from your lungs, damaging cells all around your body.  Cigarette smoke also affects cholesterol levels, which can increase your risk of a stroke.

When you inhale cigarette smoke, you inhale carbon monoxide which reduces the oxygen in your blood and nicotine which makes your heart beat faster and raises your blood pressure. This raises your risk of a stroke.

Smoking also increases the chance of a blot clot forming in your brain, because the chemicals in smoke make the platelet cells in your blood more likely to stick together.  A blood clot can block the blood supply leading to your brain.

The good news is that stopping smoking will reduce your risk of a stroke and those who have already had a stroke can reduce their risk of having another one by quitting.

Dementia

The two most common forms of dementia, Alzheimer’s disease and vascular dementia, are both linked to problems with the vascular system – the heart and blood vessels. As a result smoking, which affects the vascular system by restricting the amount of oxygen in the bloodstream, increases the risk of developing dementia.

Meanwhile the toxic chemicals present in tobacco smoke can also increase inflammation in the brain which can also lead to the developing of Alzheimer’s Disease.

Some researchers estimate that 14% of dementia cases worldwide are attributable to smoking.   According to Bob Woods, Emeritus Professor of Clinical Psychology of Older People at Bangor University, 10% of cases of dementia in the UK may be linked to smoking .   He said however, that giving up smoking decreases the risk of developing dementia, in some cases to the same level as a non-smokers.

If you are a smoker who would like to quit, then click here  to find out how who can help you.